Burning And Pain In The Chest: In The Middle, On The Left, On The Right - What To Do?

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Video: Burning And Pain In The Chest: In The Middle, On The Left, On The Right - What To Do?

Video: Burning And Pain In The Chest: In The Middle, On The Left, On The Right - What To Do?
Video: Chest pain: how to distinguish between cardiac and noncardiac causes. Dr.Magesh.T MD( USA) MRCP(UK) 2023, March
Burning And Pain In The Chest: In The Middle, On The Left, On The Right - What To Do?
Burning And Pain In The Chest: In The Middle, On The Left, On The Right - What To Do?

Burning and pain in the chest: what to do?

Burning and pain
Burning and pain

Burning sensation and pain in the chest are dangerous symptoms that should definitely make a person think about their own health. In the chest is the main worker of the body - the heart. His pathologies pose a real threat to life. However, there is also the esophagus, blood vessels, and lungs. The bones and muscles that form the sternum can hurt. In addition, in women, the mammary glands are located on top, which have a developed nervous system.

To determine the nature of pain, one should start from the place of concentration of painful sensations, as well as from additional symptoms that accompany the discomfort in the chest. The fact is that in some cases, chest pain requires immediate medical attention.


  • Pain on the right side of the chest
  • Pain in the middle of the chest and on the left
  • Chest pain and eating
  • If there is a feeling of heat in the chest when lying down
  • Chest pain during inhalation
  • Chest pain not related to external circumstances
  • Burning and chest pain treatment
  • If acute pain occurs suddenly, what should I do?

Pain on the right side of the chest

Pain on the right side of the chest
Pain on the right side of the chest

If pain occurs on the right side of the sternum, then this may signal the following conditions:

  1. Pathology of the liver and biliary tract. Characteristics of pain with impaired liver and biliary tract function:

    • The pain is dull, has a paroxysmal character.
    • Pain has no relation to body position.
    • The pain can radiate to the neck, right arm and shoulder blade.
    • The pain will intensify when the person has eaten fatty or fried foods. Such products may be disgusted at all.

    In case of violations in the hepatobiliary system, the tongue becomes covered with a yellow coating, a taste of bitterness appears in the mouth. With stones in the biliary tract, or with the formation of a tumor in them, the sclera of the eyes will also turn yellow, and then the skin. The urine darkens and the stool becomes discolored. According to similar symptoms, hepatitis, cirrhosis and hepatosis develop. Only a doctor can make the correct diagnosis, so you need to seek help from a specialist.

  2. Other pathologies of the digestive system. Various pathologists of the digestive system can manifest themselves as painful sensations in the chest. A person can suffer from gastritis, stomach ulcers, intestinal colic. Nevertheless, pains in the right side of the chest with pathologies of the gastrointestinal tract are not often localized, in the overwhelming majority of cases they are concentrated in the center of the sternum. Such pains always have a relationship with food intake.

  3. Intercostal neuralgia. With inflammation of the nerve fibers that run to the intercostal muscles, a person will experience chest pain. Often herpes zoster leads to a similar pathology, which is a complication of chickenpox. In addition to pain, a person suffers from a blistering rash that appears in the spaces between the ribs.

    The following symptoms indicate intercostal neuralgia:

    • Intense pain that burns the muscles from the inside out.
    • The pain has a clear localization.
    • When you turn the body, with a blue breath, when you cough, the pain increases.

    If the cause of the inflammation of the nervous tissue is hidden in osteochondrosis, then in addition to pain, the person will notice frequent lumbago in the right arm or neck. On palpation of the spinal column, one of its vertebrae will be especially painful.

  4. Pneumonia. With pneumonia, chest pain may occur. Besides pain, pneumonia is manifested by the following symptoms: lack of appetite, impaired well-being, fever, severe cough. During a cough, purulent sputum, or sputum with blood impurities, may leave. Breathing during the height of the illness will be difficult.

  5. Intercostal myositis. Myositis is an inflammation of the muscles that are located between the ribs. The pain is concentrated in a specific place, and tends to intensify at the time when the person starts to move, breathes deeply or coughs. There is no pain at rest.

  6. Scoliosis. Scoliosis of the thoracic spine is quite rare. It can be C-shaped or S-shaped. When the bend is directed to the right side, the vertebrae and the nerves coming from them are pinched, which causes pain.

    Other signs that are characteristic of scoliosis:

    • The pain is concentrated in one specific place, a person can point to its source without any problems.
    • The pain increases during coughing and breathing.
    • There are no signs of infectious inflammation or poisoning. The general well-being of a person is not disturbed.
  7. Chest pain and PMS. Chest pain before menstruation begins may be due to swollen breasts. Most often, both breasts become painful, but pain may also appear on one side.

  8. Symptoms such as pain in the chest before menstruation and the presence of nodules in it will indicate mastopathy.
  9. Diseases of the psyche. Chest pain can occur after a strong nervous shock, after stress, or against the background of chronic fatigue syndrome. At the same time, neither the person himself nor the doctor is able to determine any other cause of pain. There are no symptoms of infection or inflammation, and the respiratory and cardiovascular systems are fully functional.

Pain in the middle of the chest and on the left

Pain in the middle of the chest and on the left
Pain in the middle of the chest and on the left

The causes of pain concentrated in the center of the sternum or on the right side can be very diverse:

  1. When there is a cough. When, in addition to chest pain, a person suffers from coughing, this may indicate the following diseases:

    • Pneumonia with pleurisy. The pain is concentrated mainly on the left side, but not behind the sternum and not between 3-5 hypochondria to the middle of the clavicle. The pain becomes more intense if the person tries to take a deep breath. In addition, his general health is disturbed, the body temperature most often reaches high values, shortness of breath appears. It should be taken into account that with tuberculous pneumonia with pleurisy, the body temperature can remain within normal limits all the time. Sometimes pneumonia is accompanied by vomiting, but violations of the respiratory system are not observed.

    • Inflammation of the bronchi. Pain in bronchitis is concentrated in the center of the chest. During a cough, phlegm leaves, which may contain not only mucus, but also pus. In addition, the patient's body temperature rises and appetite disappears.

    • Flu. When the human body is affected by the influenza virus, pain occurs behind the sternum, the trachea suffers primarily. Flu is always accompanied by fever, pain and aches in muscles and joints. A cough appears on the first day of illness, but rhinitis most often manifests itself no earlier than the third day from an infection that has occurred.

    With hemorrhagic pneumonia, the body temperature rises, breathing becomes difficult, the symptoms of intoxication of the body increase. The pain does not shift, it is always concentrated in the chest area, since the disease is characterized by the saturation of the lung tissue with blood. Therefore, when the pain migrates, you can reject such a diagnosis as hemorrhagic pneumonia.

  2. Pain with fatigue. If chest pain appears against the background of overwork, vegetative-vascular dystonia or mental disorders can be suspected.

    With VSD, the pain is concentrated in the area of the heart muscle, it is not too strong, it does not occur after physical exertion. With a change in body position or with deep breathing, the pain does not intensify. Symptoms associated with VSD: increased sweating, hot flashes.

    If the cause of pain is mental illness, then a person may become aggressive without apparent motivation, he has depressive moods, and his appetite may deteriorate. At the same time, there are no symptoms of physical trouble: body temperature remains within normal limits, nausea and weakness are absent.

  3. Pain after exercise. The pathology of the heart muscle can be indicated by pain in the sternum that occurs after exercise. They are able to signal diseases such as ischemia, angina pectoris, myocardial infarction, myocarditis, cardiomyopathy.

    Moreover, we are talking about those pains that arise not only after doing hard physical work, but also after walking fast, after going out into the cold and performing simple physical actions there, after climbing the stairs.

    When pain appears exclusively after performing certain movements, then myositis or intercostal neuralgia can be suspected.

  4. Exertional angina

    Symptoms of exertional angina:

    • The pain is concentrated in the area of the right edge of the sternum to the middle of the clavicle horizontally and between 3-5 intercostal spaces vertically. If you visually draw lines in the indicated direction, you get a square of pain characterizing angina pectoris.
    • The pain may radiate to the left scapula and to the jaw on the left side. She can also give to the hand and reach the little finger.
    • The pain is dull, a person may feel as if the heart is constricting or pressure is being exerted on him.
    • If you rest a little, then the pain decreases, and with physical exertion, on the contrary, it increases. In some cases, the pain may become more intense after eating or after a nervous strain.
    • Taking nitroglycerin relieves the onset of pain.
    • When you cough or perform certain movements, the pain does not get worse.
  5. Myocardial infarction. Myocardial infarction is characterized by sharp pain, which is always accompanied by attacks of angina pectoris. Moreover, the attacks are becoming more frequent, and for their appearance, pronounced physical activity is no longer needed. Sharp pain during a heart attack occurs unexpectedly for a person, it cannot be stopped by taking nitroglycerin. The pain radiates to the left arm, jaw and scapula, the person becomes covered with cold sticky sweat, suffers from shortness of breath and dizziness. The heart rhythm is severely disturbed.

  6. Myocarditis. Myocarditis is an inflammation of the heart muscle. Most often, pathology develops at a young age. The causes of myocarditis are varied: poisoning of the body, infectious diseases, autoimmune processes.

The pains are concentrated in the region of the heart, while there are disturbances in its rhythm, shortness of breath, swelling of the lower extremities. Periodically, the pain disappears, and then recurs with renewed vigor.

Chest pain and eating

Chest pain and eating
Chest pain and eating

If chest pain appears after or before a meal, then it indicates a pathology of the digestive system. It can be reflux esophagitis, gastritis, stomach ulcer, inflammation of the pancreas, intestinal colic, esophageal cancer, or foreign body in the throat. Depending on the specific type of disease, its symptoms will differ.

If the esophagus is damaged, then the pain is concentrated mainly in the center of the sternum. She will bother a person when he makes swallowing movements.

If the patient's stomach is affected, then the pain appears after eating and is localized in the lower part of the chest.

When the duodenum is involved in the pathological process, the pains manifest on an empty stomach.

With inflammation of the pancreas, pain will appear about 1.5 hours after eating. Discomfort will be felt slightly below the ribs.

If there is a feeling of heat in the chest when lying down

If pain and burning sensation occurs after a person has eaten and assumed a horizontal position, then this is a symptom of reflux esophagitis. In this case, from the stomach, its contents are thrown into the esophagus, which is expressed by severe heartburn. A person does not experience a deterioration in appetite, his body temperature does not rise, his general well-being is not disturbed.

The danger of this disease lies in the fact that acid damages the wall of the esophagus, forming a non-healing defect on it. In this place, a cancerous tumor may begin to form. As the neoplasm grows, the patient may notice that hoarseness appeared in his voice, coughing began to disturb. At first, there is difficulty in swallowing solid, and then liquid food.

Chest pain during inhalation

If the pain is localized in the left side of the chest and occurs during a deep breath, then this may indicate a pathology of the heart muscle. Its inflamed membranes come into contact with the chest, which is reflected by pain. Also, pain that occurs on the left when inhaling can be a sign of pleurisy and intercostal neuralgia.



Pericarditis occurs in two forms:

  • Dry pericarditis. The outer shell of the heart muscle becomes inflamed, but it does not emit inflammatory exudate. Symptoms of such pericarditis: cough, pain in the heart, which tend to intensify during a deep breath, when food is swallowed. When a person sits, the pain is muted, and when he lies down, it becomes stronger.

  • Pericardial effusion. In this form of inflammation, the lining of the heart muscle produces an inflammatory fluid. It accumulates inside the bag and puts pressure on the vessels of the heart, as well as on the heart itself. Symptoms of exudative pericarditis: pressing heart pain, increased body temperature, hiccups, shortness of breath, feeling of a lump in the throat when swallowing food.


Pleurisy is an inflammation of the lining of the lung. This process can be accompanied by the release of exudate and take place without it. Pleurisy is not an independent pathology, but a consequence of pneumonia, lung cancer or tuberculosis.

If the left lung is affected by dry pleurisy, then the pains are localized on the left side, radiating to the peritoneum and hypochondrium. The pain becomes more intense when taking a deep breath, as well as when turning the body. If a person lies on his left side, it becomes easier for him.

When fluid begins to accumulate between the layers of the lung membrane, it will press on the heart and chest muscles. In this case, chest pains will be dull, shortness of breath and weakness will appear. The person will begin to suffer from lack of air, the temperature will rise to feverish levels.

Chest pain not related to external circumstances

Chest pain
Chest pain
  1. Atrial fibrillation and mitral valve prolapse are manifested by sudden chest pains. Moreover, the pain is not intense, has no relationship with breathing, does not increase with a change in the position of the body. However, both of these conditions require urgent medical attention, otherwise the person is in danger of death.
  2. Pathologies of the aorta and pulmonary artery are expressed by severe chest pain. These include:

    • Aortic dissection. This disease is life threatening. If you do not call an ambulance, the person will die. The condition is characterized by intense pain that is localized in the center of the chest, with a shift to the left side.

    • Blockage of the pulmonary artery by a thrombus is manifested by acute pain in the chest. It is impossible to stop it by taking nitroglycerin. Other symptoms of thromboembolism: cough, shortness of breath, brown sputum discharge. The patient is often unconscious.

  3. Cancer diseases. These include:

    • Tumors of the cardiovascular system. The pain is constantly present, at first it is weak, but over time its intensity increases. A tumor of the respiratory system can manifest itself in a similar way. Therefore, with the appearance of pain in the chest, one can suspect cancer of the lung, bronchi, pleura, myxedema of the heart.

    • Cancer lesions of the mammary gland when the tumor grows into the sternum will manifest itself as pain. The breast itself becomes deformed, a node can be palpated in it, discharge appears from the nipples.

Burning and chest pain treatment

Burning and pain treatment
Burning and pain treatment

There are many diseases that can lead to chest pain. Each of them is treated in its own way. Therapy should be prescribed only by a doctor, after a full diagnosis.

Until you contact a specialist, you can use the following recommendations:

  • The pain is concentrated in the center of the chest, or on the left: you need to stop any physical activity and rest. You can take a Nitroglycerin tablet. When the pain is relieved, you should make an appointment with a cardiologist.
  • If breathing difficulties are observed against the background of chest pain, then an ambulance team should be called immediately.
  • If the pain is very intense and is concentrated in the left side of the chest, or in its center, you need to take a Nitroglycerin tablet, open the window and call an ambulance. While waiting for doctors, you can take 1 tablet of Aspirin or another drug based on it.
  • If the pain is concentrated in the mammary gland, then you need to go to an appointment with a mammologist.
  • When pain is associated with a cough, an X-ray or CT scan should be done. With the results ready, you need to go to an appointment with a therapist and follow the doctor's recommendations.
  • If pain appeared after an infection, or occurs against the background of physical exertion, you should make an appointment with a cardiologist as soon as possible. You will definitely need to undergo an ultrasound of the heart and an ECG.
  • When the pain is very strong, the chest is bursting from the inside and arose against the background of general well-being, it is necessary to call an ambulance.

Until the doctor examines the person, you need to try to stop taking any pain medications. Otherwise, making the correct diagnosis can be significantly difficult.

To minimize the risks of developing all kinds of pathologies, you need to eat right, take walks and give up bad habits.

If acute pain occurs suddenly, what should I do?

Pain in the upper abdomen due to perforation of a stomach or duodenal ulcer

Pain in the upper abdomen
Pain in the upper abdomen

If the ulcer perforates, then the pain will be very sharp, patients indicate a feeling as if they were pierced with a knife. The pain forces the person to press their knees to the stomach and bend over.

In parallel, there are signs of a shock state:

  • The heart rate increases to 100 beats / min.
  • Blood pressure drops sharply.
  • Cold sweat comes out.
  • Consciousness becomes fuzzy.

The front wall of the peritoneum in the upper part is pulled inward, and after a short time the abdominal muscles come into hypertonicity, becoming stiff like a board.

When the gastric wall ruptures, the contents of the stomach, which contains hydrochloric acid and pepsin, are released into the hole. This leads to the development of chemical inflammation of the abdominal cavity.

Most often, the perforation of the ulcer occurs at a time when the disease is exacerbating, although sometimes the so-called "silent ulcer" can behave in a similar way. The average age group of patients is 40 years old. Moreover, women suffer from such a violation much less often.

If there is a suspicion that a person has a perforation of an ulcer, then it is necessary to call doctors as soon as possible. Treatment is only surgical.

Myocardial infarction and acute pain in the chest and upper abdomen

Myocardial infarction
Myocardial infarction

The gastralgic form of myocardial infarction is expressed in the occurrence of intense pain in the upper sternum. Pain in the abdomen occurs when the left ventricle and the interventricular septum are damaged. It is these parts of the heart that are closest to the diaphragm, which causes the corresponding symptoms.

In addition to the pain, the person will feel nauseous, he may vomit. You can suspect damage to the heart muscle by the following signs:

  • Shortness of breath that occurs during complete rest, or against the background of minor physical activity.
  • The person feels his own heartbeat. The heart works intermittently, the pulse is unstable.
  • Blood pressure is increased or, on the contrary, decreased.

The pain is always worse during excitement or during physical strain. To clarify the diagnosis, you need to undergo an ECG. All patients with myocardial infarction should be urgently admitted to the intensive care unit for intensive care.

Pain associated with acute inflammation of the pancreas

Pain associated with acute inflammation
Pain associated with acute inflammation

If a person develops inflammation of the pancreas, then the pain will sweep the body like a belt. The attack happens unexpectedly, it is not preceded by any prerequisites. Pancreatitis is associated with the fact of a gross violation of the diet, when a person eats very fatty foods in combination with the intake of alcohol.

The pain is diffuse, it radiates into the subclavian region on both sides, shoots into the lumbar spine and under the shoulder blades. Other symptoms of pancreatitis: nausea, episodes of vomiting, after which the pain only becomes more intense.

When the digestive system is working properly, the pancreas secretes enzymes, which enter the intestines and stomach and take part in the digestion of food. If the organ becomes inflamed, these enzymes begin to eat away at the gland. When the disease has a severe course, necrosis of the tissues of the pancreas and general intoxication of the body develops.

Pain in the upper abdomen and symptoms of intoxication make it possible to suspect pancreatitis even before special studies were conducted. Signs of toxemia with inflammation of the pancreas:

  1. Blue discoloration of the face and body. Cyanosis of the extremities is less common.
  2. Subcutaneous bruising in the form of irregular patches that appear on both sides of the abdomen.
  3. Small bloody rash around the navel and buttocks.

The symptoms of pancreatitis require immediate hospitalization of the patient. Most often, it is possible to do without surgical intervention. The operation is carried out with the development of organ necrosis, or with its suppuration.

Pain against the background of acute inflammation of the gallbladder and with hepatic colic

Pain in the background
Pain in the background

Hepatic colic is manifested by severe pain, the cause of which is the obstruction of the biliary tract against the background of gallstone disease. The stones prevent the normal flow of bile, which leads to vasospasm.

The pain will be concentrated under the ribs on the right side. It proceeds as contractions. It can radiate under the scapula, under the collarbone and above.

The person will feel sick, vomiting will not bring relief. If an attack of hepatic colic has an uncomplicated course, then it can be eliminated by taking antispasmodics.

When the pain can be stopped for a short period of time, and at the same time the person's body temperature rises and signs of body poisoning increase, then acute cholecystitis should be suspected. This pathology is an inflammatory process in which the gallbladder is involved. Cholecystitis is often the result of gallstone disease. An exacerbation develops at night, a few hours after eating fatty foods. There are statistics that women who have gone through childbirth and have fair skin and blonde hair are more susceptible to attacks of cholecystitis.

If symptoms of acute cholecystitis occur, the patient must be hospitalized. The further treatment regimen directly depends on the patient's condition. In some cases, it will not be possible to do without surgery. If there are no indications for immediate surgical intervention, then it is possible to carry out drug therapy using antibacterial drugs and antispasmodics. Provided that after a day there is no improvement in well-being, an operation is necessary.

Subphrenic abscess as a cause of acute pain

Subphrenic abscess
Subphrenic abscess

A subphrenic abscess is a formed purulent bladder that is located in the upper part of the peritoneum, but limited by the diaphragm. Pathology is manifested by abdominal pain, which radiates under the collarbone and under the shoulder blades. The pain can be aching, but not too intense, or it can be sharp and severe. It grows during deep breathing, with laughter and coughing.

The reason for the development of an abscess may be surgery on the stomach or duodenum, removal of the gallbladder or part of the pancreas. It is also capable of developing against the background of acute infectious inflammation in the body, for example, with pneumonia or pleurisy, against the background of inflammation of the gallbladder or vermiform appendix.

In addition to pain, a person will suffer from increased body temperature, lack of appetite, lethargy.

It is impossible to hesitate in seeking medical help, the patient needs urgent medical attention, namely, an emergency operation. Otherwise, the pathology will end in death.

Closed liver injury as a cause of sudden pain

Closed liver injury
Closed liver injury

A ruptured liver due to an injury is a serious complication that requires emergency care. This condition manifests itself in sharp pains.

The liver has a rather large weight and high density, but the elasticity of its walls is low, so it is very easy to injure the organ. This is also facilitated by the anatomical arrangement of the organ.

The most common causes of liver damage are:

  • Falling from a height of a multi-storey building.
  • An unsuccessful fall from a height of one's own growth.
  • Getting into an accident.
  • Industrial injuries.
  • Strong blow to the stomach and right side.

Any pathology of the liver contributes to the fact that the organ will be damaged even if a minor injury is received. In this case, the pain occurs on the right side, radiating to the clavicle and to the scapula. The stronger the injury, the more intense the pain. It is unbearable for a person with a ruptured liver to lie down; some relief occurs in a sitting position, with an emphasis on hands.

The following signs will indicate internal bleeding:

  • The pulse becomes very fast.
  • Blood pressure drops sharply.
  • The skin becomes pale.
  • The person has a cold sweat.
  • Bradycardia develops when bile enters the systemic circulation.

Bleeding cannot stop on its own in case of liver injury, since blood, when interacting with bile acids, loses its ability to coagulate.

A patient with liver injury needs emergency surgery. The prognosis is determined by the severity of the injury.

Sometimes it happens that the liver capsule remains intact, and the organ itself has suffered from injury. In this case, over a period of time, blood will accumulate inside the capsule, and then it will rupture. This condition is dangerous, first of all, because it is very difficult to diagnose the onset of internal bleeding. A person with a ruptured liver will be in a state of shock, so, despite the pain, he may not seek medical help, but go home. Such a gap is called two-moment.

Despite the severity of the condition, the victim will not experience pain adequate to the situation. This period is called the light interval. It can last for several hours, or even several days. Very often, this condition is fatal. Therefore, after receiving any, even at first glance, non-serious abdominal trauma, it is necessary to go to the hospital and undergo an ultrasound of the abdominal cavity.

Spleen rupture as a cause of acute pain

Ruptured spleen
Ruptured spleen

The spleen ruptures much less often than the liver, since it is smaller and located deeper in the human body, which means it is better protected. When an organ ruptures, the pain will be concentrated in the upper abdomen, on the left. It radiates under the left shoulder blade and into the left collarbone. The rest of the symptoms are similar to those of a ruptured liver.

To make the correct diagnosis, an ultrasound scan is necessary. Sometimes a rupture of the spleen can happen not from injury, but as a result of an illness, when the organ increases in size. In this regard, various types of blood cancer, malaria, tuberculosis, etc. pose a danger. Even a slight push into the left hypochondrium, a sharp turn of the body, strong laughter or a cough can provoke an organ rupture against the background of the disease.

You should consult a doctor immediately if you have signs of ruptured spleen. The organ must be removed if the rupture was massive. For minor injuries, the spleen may simply be sutured. If assistance was provided in a timely manner, then the prognosis is favorable. A person is able to live without a spleen as long as a person whose organ has not been removed.

Inflammation of the lungs and pleurisy as a cause of acute pain


Pain in the upper abdomen can signal the development of pneumonia. The right lung is bordered by the right dome of the diaphragm, so the pain is localized on the right side of the peritoneum.

The pain can be severe, accompanied by tension in the abdominal muscles. This is often the cause of a misdiagnosis, such as cholecystitis or appendicitis. To correctly recognize pneumonia, it is necessary to focus on such a sign as high body temperature. In addition, the patient will suffer from shortness of breath, the face will turn red, and rashes resembling herpes may appear on the lips, cheeks and neck.

If treatment is started on time, the prognosis is quite favorable.

With pleurisy, pain is localized in the upper abdomen, as inflammation of the pleura provokes irritation of the intercostal nerves. The pain gets worse during deep breathing, so people with pleurisy intentionally breathe shallowly to reduce pain.

Pleurisy requires a comprehensive examination of the patient, since the cause of its development may be a malignant tumor of the lung, infarction of its tissues and other serious pathologies. The prognosis is determined primarily by the etiology of pleurisy.


The author of the article: Molchanov Sergey Nikolaevich | Cardiologist

Education: Diploma in "Cardiology" received at the PMGMU. I. M. Sechenov (2015). Here I completed my postgraduate studies and received a diploma "Cardiologist".

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